Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.

<h4>Introduction</h4>Catastrophic costs incurred by tuberculosis (TB) patients have received considerable attention, however little is known about costs and pathways to care after a negative TB evaluation.<h4>Materials and methods</h4>We conducted a cross-sectional study of 7...

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Autores principales:	Thomas H A Samuels, Priya B Shete, Chris Ojok, Talemwa Nalugwa, Katherine Farr, Stavia Turyahabwe, Achilles Katamba, Adithya Cattamanchi, David A J Moore
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fa0b4173480f49c98680035a976d6216
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spelling	oai:doaj.org-article:fa0b4173480f49c98680035a976d62162021-12-02T20:06:55ZWhere will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.1932-620310.1371/journal.pone.0253927https://doaj.org/article/fa0b4173480f49c98680035a976d62162021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253927https://doaj.org/toc/1932-6203<h4>Introduction</h4>Catastrophic costs incurred by tuberculosis (TB) patients have received considerable attention, however little is known about costs and pathways to care after a negative TB evaluation.<h4>Materials and methods</h4>We conducted a cross-sectional study of 70 patients with a negative TB evaluation at four community health centres in rural and peri-urban Uganda. Patients were traced 9 months post-evaluation using contact information from TB registers. We collected information on healthcare visits and implemented locally-validated costing questionnaires to assess the financial impact of their symptoms post-evaluation.<h4>Results</h4>Of 70 participants, 57 (81%) were traced and 53 completed the survey. 31/53 (58%) surveyed participants returned to healthcare facilities post-evaluation, making a median of 2 visits each (interquartile range [IQR] 1-3). 11.3% (95%CI 4.3-23.0%) of surveyed patients and 16.1% (95%CI 5.5-33.7%) of those returning to healthcare facilities incurred catastrophic costs (i.e., spent >20% annual household income). Indirect costs related to lost work represented 80% (IQR 32-100%) of total participant costs.<h4>Conclusions</h4>Patients with TB symptoms who experience financial catastrophe after negative TB evaluation may represent a larger absolute number of patients than those suffering from costs due to TB. They may not be captured by existing definitions of non-TB catastrophic health expenditure.Thomas H A SamuelsPriya B SheteChris OjokTalemwa NalugwaKatherine FarrStavia TuryahabweAchilles KatambaAdithya CattamanchiDavid A J MoorePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253927 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thomas H A Samuels Priya B Shete Chris Ojok Talemwa Nalugwa Katherine Farr Stavia Turyahabwe Achilles Katamba Adithya Cattamanchi David A J Moore Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.
description	<h4>Introduction</h4>Catastrophic costs incurred by tuberculosis (TB) patients have received considerable attention, however little is known about costs and pathways to care after a negative TB evaluation.<h4>Materials and methods</h4>We conducted a cross-sectional study of 70 patients with a negative TB evaluation at four community health centres in rural and peri-urban Uganda. Patients were traced 9 months post-evaluation using contact information from TB registers. We collected information on healthcare visits and implemented locally-validated costing questionnaires to assess the financial impact of their symptoms post-evaluation.<h4>Results</h4>Of 70 participants, 57 (81%) were traced and 53 completed the survey. 31/53 (58%) surveyed participants returned to healthcare facilities post-evaluation, making a median of 2 visits each (interquartile range [IQR] 1-3). 11.3% (95%CI 4.3-23.0%) of surveyed patients and 16.1% (95%CI 5.5-33.7%) of those returning to healthcare facilities incurred catastrophic costs (i.e., spent >20% annual household income). Indirect costs related to lost work represented 80% (IQR 32-100%) of total participant costs.<h4>Conclusions</h4>Patients with TB symptoms who experience financial catastrophe after negative TB evaluation may represent a larger absolute number of patients than those suffering from costs due to TB. They may not be captured by existing definitions of non-TB catastrophic health expenditure.
format	article
author	Thomas H A Samuels Priya B Shete Chris Ojok Talemwa Nalugwa Katherine Farr Stavia Turyahabwe Achilles Katamba Adithya Cattamanchi David A J Moore
author_facet	Thomas H A Samuels Priya B Shete Chris Ojok Talemwa Nalugwa Katherine Farr Stavia Turyahabwe Achilles Katamba Adithya Cattamanchi David A J Moore
author_sort	Thomas H A Samuels
title	Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.
title_short	Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.
title_full	Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.
title_fullStr	Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.
title_full_unstemmed	Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.
title_sort	where will it end? pathways to care and catastrophic costs following negative tb evaluation in uganda.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/fa0b4173480f49c98680035a976d6216
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Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.

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